How to handle trauma professionally

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Trauma is not just a much talked about topic right now, it is a part of human existence. What we could not process in the past remains as a trauma in our body and nervous system.

Anyone who professionally works with people – has an impact on their body and system – will therefore also  to deal with trauma – whether one ‘explicitly’ wants to work with it or not. Because the unprocessed (traumatic) elements of the past are reflected in our sessions: as behavioral and tension patterns, behavior and perspectives, all the way to beliefs, self-images and worldviews.

The only question for each of us as bodyworkers, coaches, as well as trainers & yoga teachers is: Can I handle trauma professionally, if it shows up?

This does not mean that everyone of us has to work as a trauma-therapist. However, we  in Holistic Bodywork believe it is our responsibility as a professional people-worker to ensure that at least we do not reinforce old injuries and the resulting patterns ( More in our Retraumatizing – Article ) .

That’s what this article is about.

How can bodywork activate trauma?

This is a short presentation. (You can find an in depth article here)

From a neurophysiological point of view, trauma is an uncompleted state of survival-energy in  the autonomic nervous system (ANS): We experienced a dangerous situation, it activated our ANS which could not re-regulate afterwards. 
If this happens, this activation is chronically available in the nervous system and body and can thus be easily “triggered” – even in situations that are not actually dangerous. Triggers can be memories, movements, certain body perceptions, postures or touch.

In a treatment, we can easily activate these by talking to people about their discomfort, touching and moving them or giving them exercises targeting problem areas.

Examples during a neck-treatment:

  • We ask the client since when he has this pain and about possible causes (eg a bicycle accident)
  • We massage the shoulder, which could reduce the old protective patterns, but the actual charge is still in the system, so that it increases the tension afterwards.
  • We move the cervical spine, which can trigger implicit memories of the accident, including incomplete movements, thus activating the protective tension again

How can I recognize trauma?

Before we can learn to deal with trauma, we first have to recognize it. Because our clients will seldom say, “Oh my, now the trauma from that bike crash has been reactivated due to the position of my head”. Because from the inside what they actually experience is: overwhelm, tension, anxiety or “emotionality” – without an understanding why this arises.

So it is up to us to recognize and identify the signs of trauma. This is an important ability for bodyworkers of all kinds: being able to recognize trauma or the activation of the nervous system quickly.

Physical signs to detect trauma include:

  • Sudden tensing of muscles without a physiological cause (especially fight and flight muscles)- clenching hands, tightening jaws, raised shoulders
  • Sudden collapse of muscles- collapse of upper body, loss of facial features, sagging of shoulders
  • Trembling without previous muscle fatigue
  • Changeof breathing – Highly accelerated breathing, sudden flattening of breathing or apnoe
  • Sudden change in the blood circulation
  • Loss of facial expressions, especially around the eyes and forehead à this is a very reliable sign

Psycho-emotional signs to detect trauma are:

  • Suddenlyemerging Emotions – anger, fear, sometimes grief
  • Dissociation- the person is no longer responsive, suddenly “falling asleep” or loosing muscular tension (hypotonic)
  • Impulses to orient- open eyes, looking around, uncertain questions
  • Increasingly incoherent – person can no longer respond clearly or respond to questions

IMPORTANT:
It is about sudden changes that are not clearly explained by the treatment.
AND we always collect several indicators before we form a hypothesis. Not every change in breathing is a trauma.

What this may look like during a neck treatment:

Situation: The practitioner mobilizes the cervical spine in supine position and turns the head of the client to the side to massage and stretch the trapezius.

Possible signs of trauma:

  • The client grows pale, suddenly opens his eyes and looks around with the corner of his eyes
  • Feedback to questions is short, imprecise and given with a monotone voice s, or the client is even suddenly “gone”
  • The tension of the muscle suddenly increases sharply and the shoulder is pulled up
  • The tension dissappears suddenly – it is not a slow relaxation, but a drop

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What can I do when trauma comes up?

To deal professionally with trauma, small things often help. Once we realized what is happening, we have already taken the most important step.

Because it is then possible to deliberately do something that helps the client feel more secure here and now – and perhaps even discharge a portion of the tension.

Here are a few simple tools from trauma-therapy you can orient towards:

  1. Recognize and respect boundaries

Recognizing boundaries is indispensable in trauma-sensitive bodywork, because change happens at a person’s boundaries – not beyond them or even without them.

It is important to listen to the subtle signals that say “stop,” or “slow down” even if we believe that the maximum impact the tissue can handle has not yet been reached.

One of the basic rules in HB is that every boundary is good for something. We want to recognize and respect even the small impulses of the client – because this enables completely new paradigms of treatment, s. Point 2 for that.

  1. Follow (physical) impulses of the client

Once we find a boundary, it is paramount to listen to the impulses of the client without pushing or manipulating. Because frequently healing impulses will naturally arise from the body and psyche of the client when we stay with a boundary:

  • With shock-trauma there are often unfinished movements (the body wanted to curl up and protect itself during a bicycle accident), the completion of these movements relaxes the entire system – it can feel safe again.
  • Developmental trauma is often expressed in protective postures ( eg, raising one’s shoulders when one expects to be hurt) and many approaches want to break through these postures (armor). In our opinion, it is much more humane and effective to offer support to the protection so that it can relax without being broken.

When these impulses recognized, valued and respected, healing and next developmental steps often happen by themselves.

  1. Provide a safe container for discharge

Should there be a physical or emotional discharge in the session (shaking, fear, sadness…), it is important to offer a safe container. A container includes openness and boundaries.

a) Welcome unloading – The client is welcome just as he is. That is, we also welcome strong emotions, young parts and physical reactions. 
It is important for us as clinicians to feel secure in ourselves as well as knowing and understand these dynamics.

b) Ensure safety – At the same time it is also important to stand for clarity and  With trauma, it is very easy to get lost in emotions, sensations and old stories (“trauma-vortex”).This is NOT helpful but can instead lead to more dysregulation, regression and fragmentation (“retraumatization”) . 
We offer security by being open and setting boundaries, returning to resources and helping the client understand what is happening .

  1. Find orientation in the here and now

Trauma comes from the past – but we experience the fear, stress and tension patterns as if they were needed right now. Through orientation we can question and check this. We use orientation as a tool in two ways:

a) Helping clients orient themselves here and now – With questions like:

  • Are you aware of a danger right now?
  • How does the ground feel beneath you?
  • Do you have any impulses along with this tension?

b) Providing cognitive orientation to the client –As a practitioner, it is important to be able to offer the client a mental orientation so that he understands what is happening in him:

  • Why do the muscles tighten again and again?
  • Why does fear come up when we work on the neck?
  • How can the bicycle accident still impact him?

This understanding is important so that the results of the treatment can be processed and digested in the long term.

Some last words

We hope this outline gives you a few ideas on how you can better recognize trauma in the future and handle it professionally.

If you have questions, feel free to contact us. This topic is very important to us, because in our daily practice we are again and again confronted with people, where exactly this went wrtong – in both roles, therapist and clients.

We hope that more therapists will use and internalize this knowledge so that we can sustainably help more and more people.

Treatment Approaches for Shock-Trauma

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